Michael J. Guralnick

Effectiveness of Early Intervention for Vulnerable Children: A Developmental Perspective

An analysis of the current state of our knowledge of the effectiveness of early intervention for children at risk and for those with established disabilities was provided. A model focused on childrens cognitive development was presented in which early intervention is placed firmly within a developmental framework. Both short- and long-term effects, the mechanisms through which early intervention exerts its influence, the relation between those mechanisms and the organization of existing service systems, current limits of programs, and prospects for future research were considered in this model.

Family and child influences on the peer‐related social competence of young children with developmental delays

Young children with developmental (cognitive) delays experience unusual difficulties in establishing relationships with their peers and developing friendships. A conceptual model of childrens peer-related social competence is presented by identifying information-processing and emotional regulation processes governing the production of social strategies occurring during social tasks. Contemporary family factors and childrens cognitive, communicative, and behavioral characteristics that influence the development of these processes are discussed and form the framework for designing intervention programs to promote childrens peer-related social competence. The interplay between the fields of child development and developmental disabilities is emphasized. MRDD Research Reviews 1999; 5:21–29.

Social Competence and Early Intervention

This article explores the relationship between young childrens social competence and the goals of early intervention programs. Social competence is seen as a central organizing construct in development, and competence with peers during the preschool years is examined in detail. Specifically, the peer-related social competence difficulties of handicapped children are discussed from a developmental perspective. The nature of assessment and intervention strategies and the importance of the social context are described as part of a general program to improve the peer-related social competence of handicapped children. It is concluded that the social context provided by mainstreamed programs establishes essential conditions forpromoting the peer-related social competence of handicapped children.

A Developmental Systems Model for Early Intervention

The article presents a rationale for and components of a developmental systems model to guide early intervention programs for vulnerable children and their families. Core principles emphasizing a developmental framework, integration, and inclusion, as well as related principles, are expressed in the

Why Early Intervention Works: A Systems Perspective.

A systems perspective is put forward designed to place the many diverse conceptual and practice approaches and accomplishments in the early intervention field within a common framework. Complex reciprocal patterns of influence are described emphasizing risk and protective factors operating at 3 levels: child social and cognitive competence, family patterns of interaction, and family resources. It is argued that this framework can provide an understanding with respect to why early intervention works when it does as well as establish a new assessment and intervention approach firmly grounded in developmental science.

Peer Interactions in Mainstreamed and Specialized Classrooms: A Comparative Analysis

The peer interactions and cognitive levels of play of mildly developmentally delayed preschool children were compared as they participated in mainstreamed and in specialized settings. When in mainstreamed playgroups, delayed children engaged in a substantially higher rate of peer-related social behaviors and played more constructively. In relation to previous findings, these results suggested that the proportion of nonhandicapped children in mainstreamed settings and the availability of children similar in chronological age to the delayed children are important programmatic factors in early childhood mainstreaming efficacy research. The potential value of mainstreamed settings as a framework for more systematic and individual treatment programs for mildly developmentally delayed preschool children also was discussed.

The Nature and Meaning of Social Integration for Young Children with Mild Developmental Delays in Inclusive Settings.

This paper examines fundamental conceptual, methodological, and outcome issues with respect to the social integration of preschool-age children with mild developmental delays in inclusive early childhood settings. Cast within a developmental-ecological framework, social integration is evaluated in terms of three constructs: (1) the connectedness of peer interactions; (2) the quality of interpersonal relationships; and (3) the nature of adjustments that occur during social exchanges. A general model of factors that influence social integration and their interrelationships is presented as a means of organizing future intervention activities to promote social integration.

Social Interactions among Preschool Children

To obtain information on the potential benefits of integration, this study investigated the nature and extent of social interactions among preschool children at different developmental levels. Communicative and parallel play interactions of mildly, moderately, severely, and nonhandicapped children were observed during free play across two time periods. The results revealed that (a) nonhandicapped and mildly handicapped children interacted with each other more frequently than expected on the basis of availability, and they interacted with moderately and severely handicapped children less frequently than expected; (b) moderately and severely handicapped children interacted with all four developmental groups as expected by the criterion of availability; and (c) whenever this pattern of interaction changed over time, it was typically in the direction of enhancing the differences noted in the first statement. These findings are discussed in terms of the potential value of integrated programs for children of varying developmental levels.

The Next Decade of Research on the Effectiveness of Early Intervention

The effectiveness of early intervention programs for children with developmental disabilities and for children at biologic risk was reviewed and analyzed. A general pattern indicating important effects of early intervention programs was noted, with effect sizes averaging between one-half and three-quarters of a standard deviation. The ability of early intervention programs to minimize declines in development was identified as a significant outcome. The effects of specific program features—age of start and family involvement—were selected for more detailed examination, and the moderating influence of the levels of severity of childrens disabilities was also analyzed. Future directions for improving the effectiveness of early intervention include, using the emerging knowledge of biobehavioral and child development research, as well as enhancing childrens social competence.

Effectiveness of Developmental Intervention in the First Five Years of Life

Developmental intervention in the first 5 years of life is an expanding, complex enterprise. Documenting efficacy by traditional scientific methods has proven to be elusive for a number of practical reasons, e.g., target population heterogeneity, methodology variability, inadequate outcome measures, and cost of longitudinal cohort designs. Nevertheless, despite these shortcomings, there is accumulating research information as to which types of intervention approaches are likely to be most beneficial to specific groups of infants and children and their families. It is quite clear that preventive strategies for at-risk children and families are different than ameliorative strategies for children with established disabilities. It is also clear that comprehensive evaluation of effectiveness must include consideration of both functional child gains (e.g., social, communication, mobility, and adaptive skills) and enhancement of family function. It is the pediatricians responsibility to be adequately informed about contemporary developmental interventions in order to balance parental hopes and needs with potential benefits.